Indapamide MV STADA
Indapamide MV STADA: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. For violations of liver function
- 13. Drug interactions
- 14. Analogs
- 15. Terms and conditions of storage
- 16. Terms of dispensing from pharmacies
- 17. Reviews
- 18. Price in pharmacies
Latin name: Indapamide MV Stada
ATX code: C03BA11
Active ingredient: indapamide (indapamide)
Producer: MAKIZ-PHARMA, CJSC (Russia), Hemofarm, LLC (Russia)
Description and photo update: 28.11.2018
Prices in pharmacies: from 76 rubles.
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Indapamide MV STADA is an antihypertensive drug, a diuretic.
Release form and composition
The drug is produced in the form of tablets of prolonged action, film-coated: round, biconvex, yellow; 2 layers are visible in the cross section, the inner (core) is almost white or white (10 pcs. in blister contour packs, 3 packs in a cardboard box and instructions for use of Indapamide MV STADA).
Composition of 1 tablet:
- active substance: indapamide - 1.5 mg;
- auxiliary components: magnesium stearate, colloidal silicon dioxide (aerosil), lactose monohydrate, hypromellose (hypromellose 4000);
- shell composition: tropeolin O, macrogol (polyethylene glycol 4000), titanium dioxide, talc, hypromellose (hydroxypropyl methylcellulose).
Pharmacological properties
Pharmacodynamics
The active ingredient of Indapamide MB STADA - indapamide, is a diuretic, antihypertensive agent.
The mechanism of action of indapamide is due to its ability to disrupt sodium reabsorption in the cortical segment of Henle's loop; therefore, in terms of pharmacological properties, it is close to thiazide diuretics.
Indapamide MB STADA increases urinary excretion mainly of chloride and sodium ions, to a lesser extent - magnesium and potassium ions.
Indapamide has the ability to selectively block slow calcium channels, thereby increasing the elasticity of the arterial walls and reducing total peripheral vascular resistance (OPSS).
The substance helps to reduce left ventricular hypertrophy of the heart. Reduces the production of free and stable oxygen radicals. Stimulates the synthesis of prostacyclin PGI2 and prostaglandin E 2. Reduces the sensitivity of the vascular wall to angiotensin II and norepinephrine (norepinephrine). At the same time, indapamide does not affect carbohydrate metabolism (including with concomitant diabetes mellitus) and the content of lipids in the blood plasma (high density lipoproteins, low density lipoproteins, thyroglobulin).
The antihypertensive effect of Indapamide MB STADA when taken 1 time per day is maintained for 24 hours. An adequate therapeutic effect develops after 6-7 days of daily intake of the drug.
Pharmacokinetics
Once in the gastrointestinal tract, indapamide is absorbed quickly and completely.
It is characterized by high bioavailability - 93%. With the simultaneous intake of food, the absorption rate slows down somewhat, but this does not affect the degree of absorption.
The maximum concentration is noted 12 hours after taking Indapamide MB STADA.
With repeated use of the drug, fluctuations in plasma concentrations of indapamide in the intervals between doses are reduced. The equilibrium state is established after 7 days of daily use of Indapamide MB STADA.
Binds to plasma proteins (by 79%), as well as elastin of the smooth muscles of the vascular wall. It has a high volume of distribution, penetrates the histohematological barriers (including placental) and into breast milk. It does not accumulate in the body.
It is metabolized in the liver. The half-life is 18 hours. It is excreted: by the kidneys - 60-80% in the form of metabolites and about 5% - unchanged, through the intestines - about 20%.
Concomitant hepatic failure does not affect the pharmacokinetics of indapamide.
Indications for use
Indapamide MV STADA is used for arterial hypertension.
Contraindications
Absolute:
- hypokalemia;
- severe renal failure (stage of anuria);
- severe liver failure (including encephalopathy);
- age up to 18 years;
- pregnancy and lactation;
- hypersensitivity to any component of Indapamide MB STADA or other sulfonamide derivatives.
Indapamide MV STADA tablets are used with caution in the following cases:
- hyperparathyroidism;
- decompensated diabetes mellitus;
- violations of water and electrolyte balance;
- impaired renal / hepatic function;
- hyperuricemia (especially if it is accompanied by gout and urate nephrolithiasis);
- an increased QT interval on an electrocardiogram or concurrent administration of drugs that can lengthen the QT interval.
Indapamide MV STADA, instructions for use: method and dosage
Indapamide MB STADA tablets should be taken orally: swallow whole and drink plenty of liquid.
Adult patients are prescribed 1 tablet 1 time per day, in the morning. There is no need to increase the dose, since the hypotensive effect does not increase.
Side effects
- allergic reactions: often - maculopapular rash; infrequently, purpura; very rarely - itchy skin, urticaria, hemorrhagic vasculitis, angioedema, Stevens-Johnson syndrome, toxic epidermal necrolysis;
- from the digestive system: infrequently - vomiting; rarely - dry mouth, nausea, constipation; very rarely - diarrhea, abdominal pain, anorexia, pancreatitis; in patients with hepatic insufficiency - hepatic encephalopathy;
- from the urinary system: very rarely - polyuria, nocturia, renal failure, infections;
- from the respiratory system: pharyngitis, sinusitis, cough, rhinitis;
- from the central and peripheral nervous system: rarely - fatigue, asthenia, headache, tension, insomnia, drowsiness, paresthesia, anxiety, malaise, irritability, irritability, muscle spasm of the limbs, depression, vertigo;
- on the part of the hematopoietic organs: very rarely - aplastic anemia, hemolytic anemia, leukopenia, agranulocytosis, bone marrow aplasia, thrombocytopenia;
- on the part of the cardiovascular system: very rarely - a feeling of palpitations, orthostatic hypotension, arrhythmia, changes in the electrocardiogram (ECG) characteristic of hypokalemia;
- laboratory indicators: a decrease in potassium levels and the development of hypokalemia (especially pronounced in patients at risk); very rarely - hypercalcemia, hyponatremia with hypovolemia and orthostatic hypotension, glucosuria, hypercreatininemia, increased blood urea nitrogen concentration; in individual cases - hyperglycemia, hyperuricemia; in case of a simultaneous loss of chlorine ions - compensatory metabolic alkalosis;
- others: in individual cases - photosensitivity reactions, exacerbation of systemic lupus erythematosus.
Overdose
An overdose of indapamide can manifest itself with the following symptoms: a marked decrease in blood pressure, disturbances in the water-electrolyte balance (hypokalemia, hyponatremia), nausea, vomiting, confusion, drowsiness, dizziness, lethargy, convulsions, respiratory depression, polyuria or oliguria up to anuria (due to hypovolemia). Hepatic coma may develop in patients with cirrhosis of the liver.
After taking an excessive dose of Indapamide MB STADA, the stomach should be flushed. In the future, correction of water and electrolyte balance and symptomatic therapy are performed. Indapamide has no specific antidote.
special instructions
If within 4-8 weeks the severity of the hypotensive effect is not enough, it is possible to add an antihypertensive drug with a different mechanism of action to the therapy. Further increase in the dose of Indapamide MB STADA is not recommended, since no significant increase in the antihypertensive effect is observed, but the risk of side effects increases.
In the elderly, patients with hyperaldosteronism and patients who receive laxatives or cardiac glycosides, the level of creatinine and potassium ions should be monitored.
All patients during drug therapy should regularly monitor the plasma concentrations of magnesium, sodium and potassium ions (for possible electrolyte disturbances), the concentration of uric acid, glucose (very carefully in patients with diabetes mellitus, especially with the concomitant presence of hypokalemia) and residual nitrogen, as well as pH level. Determination of the plasma content of sodium ions is recommended before starting treatment, potassium ions - a week after starting therapy. The most careful monitoring is required in debilitated patients, patients with heart failure, ischemic heart disease, liver cirrhosis (especially if accompanied by ascites or edema), as well as patients receiving combination therapy. The high-risk group also includes patients who have an increase in the QT interval on the ECG,or who are taking medications that can increase this interval.
With the simultaneous administration of thiazide diuretics, a decrease in the excretion of calcium ions in the urine is possible, due to which a slight and temporary hypercalcemia may develop. Severe hypercalcemia while taking indapamide may indicate the presence of hyperparathyroidism, which was not previously identified. Before examining the function of the parathyroid gland, the diuretic should be discontinued.
In patients with hepatic impairment, thiazide diuretics can cause the development of hepatic encephalopathy. Indapamide MV STADA in this case must be canceled immediately.
Severe dehydration can lead to the development of acute renal failure. Water loss should be compensated for, and renal function should be closely monitored at the start of therapy.
Derivatives of sulfonamides can exacerbate the course of systemic lupus erythematosus. This information should be taken into account when using indapamide.
With a high level of uric acid in plasma, Indapamide MB STADA may increase the incidence of gout attacks.
If doping control is carried out during therapy, it is possible to obtain a positive result.
Influence on the ability to drive vehicles and complex mechanisms
In some cases, especially at the beginning of therapy and with the addition of another antihypertensive drug, dizziness, drowsiness and some other reactions from the nervous system occur. Such patients should be especially careful when performing potentially hazardous work requiring attention and increased reaction speed.
Application during pregnancy and lactation
Diuretics can cause placental ischemia and fetal development disorders, therefore, Indapamide MB STADA is contraindicated during pregnancy.
The drug is excreted in breast milk. If treatment is necessary, breastfeeding should be discontinued.
Pediatric use
Indapamide MV STADA is not used in pediatric practice.
With impaired renal function
- impaired renal function: Indapamide MB STADA should be used with caution;
- severe renal failure (stage of anuria): the drug is contraindicated.
For violations of liver function
- impaired liver function: Indapamide MB STADA should be used with caution;
- severe hepatic insufficiency (including encephalopathy): the drug is contraindicated.
Drug interactions
Indapamide MB STADA is not recommended to be used concomitantly with lithium preparations, since indapamide reduces the excretion of lithium by the kidneys, which increases its concentration in plasma, which can lead to overdose. A similar phenomenon is possible with a salt-free diet. If the lithium preparation is necessary, its concentration in blood plasma should be carefully monitored and the dose adjusted if necessary.
Combinations requiring special attention:
- class IA antiarrhythmics (hydroquinidine, quinidine, disopyramide), class III antiarrhythmics (dofetilide, amiodarone, bretylium tosylate, ibutilide), sotalol, benzamides (sulpiride, tiapride, sultopride, amisulpride), butyrophenones (haloperidolines), dropotepomine, trifluoperazine, cyamemazine, chlorpromazine, thioridazine), moxifloxacin, pentamidine, mizolastine, astemizole, halofantrine, erythromycin (administered intravenously), difemanil, bepridil, sparfloxacin, cisapride, type of vincamine development: especially against the background of hypokalemia. If it is necessary to carry out combination therapy, the plasma potassium level should be monitored and, if necessary, adjusted. It is also recommended to monitor the patient's clinical condition and his plasma electrolyte composition. These drugs should not be used in patients with hypokalemia;
- nonsteroidal anti-inflammatory drugs of systemic action, including selective inhibitors of cyclooxygenase-2 (COX-2), salicylic acid in high doses (more than 3000 mg per day): the hypotensive effect of indapamide may decrease, acute renal failure may develop in dehydrated patients. Before you start taking these funds, you should restore the water-electrolyte balance, during their use - monitor the kidney function;
- cardiac glycosides: with hypokalemia, their toxic effect increases. When carrying out combination therapy, it is necessary to monitor the level of potassium in the plasma and the electrocardiogram indicators, if necessary, adjust the treatment regimen;
- baclofen: the antihypertensive effect of indapamide is enhanced;
- metformin: there is a high risk of developing lactic acidosis, probably associated with the development of functional renal failure under the influence of a diuretic. If the creatinine level is more than 12 mg / L (110 μmol / L) in women and 15 mg / L (135 μmol / L) in men, indapamide should not be used in combination with metformin;
- angiotensin-converting enzyme (ACE) inhibitors: with hyponatremia, the likelihood of developing sudden arterial hypotension and / or acute renal failure increases. In the event that a patient with arterial hypertension due to taking a diuretic decreases the plasma content of sodium ions, 3 days before starting an ACE inhibitor, you should stop taking Indapamide MB STADA. Treatment with an ACE inhibitor begins with low doses, gradually increasing them if necessary, in the future, the diuretic can be resumed. Treatment of patients with chronic heart failure begins with low doses of an ACE inhibitor, the dose of a diuretic is previously reduced. In all cases, during the first week of therapy, renal function (plasma creatinine) should be carefully monitored;
- potassium-sparing diuretics (spironolactone, amiloride, triamterene): hyper- or hypokalemia may develop, especially with concomitant diabetes mellitus or renal failure. When carrying out combination therapy, it is necessary to monitor the plasma level of potassium and ECG indicators, if necessary, adjust the therapy regimen;
- preparations containing calcium salts: the risk of a decrease in the excretion of calcium ions by the kidneys increases and, as a result, the development of hypercalcemia;
- indirect anticoagulants (coumarin or indandione derivatives): the volume of circulating blood decreases, the production of coagulation factors by the liver increases. Combination treatment should be administered with caution, dose adjustment may be required;
- tetracosactide and glucocorticosteroid agents (with systemic use): there is a retention of fluid and sodium ions, as a result of which the antihypertensive effect of indapamide decreases;
- antipsychotics, tricyclic antidepressants: the hypotensive effect of indapamide increases, the risk of orthostatic hypotension increases due to the additive effect;
- iodine-containing X-ray contrast agents (especially in high doses): the risk of developing renal failure increases. Before using them, you should restore the lost fluid;
- tacrolimus + cyclosporine: an increase in the level of creatinine in the blood plasma is possible, even with a normal content of sodium ions and water (without changing the concentration of cyclosporine);
- laxatives that stimulate intestinal motility, glucocorticosteroids and mineralocorticosteroids (with systemic use), tetracosactide, amphotericin B (used intravenously): the likelihood of hypokalemia increases. It is necessary to control the plasma level of potassium ions and, if necessary, adjust it;
- non-depolarizing muscle relaxants: the blockade of neuromuscular transmission caused by them increases.
When prescribing Indapamide MB STADA, the patient must inform the doctor about all the medications he is taking.
Analogs
Analogs of Indapamide MV STADA are: Acripamide, Arifon, Indap, Indapamid, Ionik, Ipres Long, Lorvas SR, Ravel SR, Retapres, SR-Indamed, etc.
Terms and conditions of storage
Keep out of the reach of children, protected from light and moisture, at temperatures up to 25 ° C.
The shelf life is 3 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Indapamide MV STADA
According to reviews, Indapamide MB STADA is an antihypertensive agent that effectively reduces high blood pressure. Its additional advantages are considered the convenience of reception (1 time per day) and relatively low cost.
The disadvantages include a possible sharp drop in blood pressure, as well as a large list of possible side effects.
Price for Indapamide MV STADA in pharmacies
The approximate price for Indapamide MV STADA for a pack of 30 tablets is 95–115 rubles.
Indapamide MV STADA: prices in online pharmacies
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Drug name Price Pharmacy |
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Indapamide MV Stada 1.5 mg film-coated tablets of prolonged action 30 pcs. RUB 76 Buy |
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Indapamide MV Stada tablets p.o. prolonged action 1.5mg 30 pcs. 119 RUB Buy |
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
